Gastroenterologie a Hepatologie最新文献

{"title":"Spontaneous intramural duodenal hematoma in a young woman","authors":"P. Vrbová, T. Koller","doi":"10.48095/ccgh2021535","DOIUrl":"https://doi.org/10.48095/ccgh2021535","url":null,"abstract":"Summary: Non-traumatic spontaneous intramural duodenal hematoma is a rare cause of proximal gastrointestinal obstruction which may present with hemorrhage, jaundice and pancreatitis. In this case report we present a case of spontaneous duodenal hematoma in a 28-year-old female with a history of acute pancreatitis, admitted to hospital for convulsive upper abdominal pain with vomiting as suspected pancreatitis. An MRI examination of the abdomen confi rmed intraluminal bleeding into the duodenum. Following supportive therapy the clinical symptoms spontaneously subsided and laboratory parameters improved. Due to early dia gnosis and therapy the patient had a good outcome, without requiring surgery. Repeated imaging showed hematoma resorption. Key words: abdominal pain – vomitus – duodenal hematoma – hemorrhage","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75010582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assistance system for real-time polyp detection based on convolutional neural network","authors":"Daniel Kvak, Karolína Kvaková","doi":"10.48095/ccgh2021540","DOIUrl":"https://doi.org/10.48095/ccgh2021540","url":null,"abstract":"Summary: The use of artifi cial intelligence as an assistive detection method in endoscopy has attracted increasing interest in recent years. Machine learning algorithms promise to improve the effi ciency of polyp detection and even optical localization of fi ndings, all with minimal training of the endoscopist. The practical goal of this study is to analyse the CAD software (computer-aided dia gnosis) Carebot for colorectal polyp detection using a convolutional neural network. The proposed binary classifier for polyp detection achieves accuracy of up to 98%, specifi city of 0.99 and precision of 0.96. At the same time, the need for the availability of large-scale clinical data for the development of artifi cial- -intelligence-based models for the automatic detection of adenomas and benign neoplastic lesions is discussed. Key words: polyp detection – convolutional neural network – artifi cial intelligence – computer-aided dia gnosis – spatial location","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78546142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of bariatric surgery in patients with type 1 diabetes mellitus","authors":"D. Pichlerová","doi":"10.48095/ccgh2021524","DOIUrl":"https://doi.org/10.48095/ccgh2021524","url":null,"abstract":"Bariatric surgery procedures are recognized as the most successful method of treating diabetes in obese patients with type 2 diabetes mellitus. Despite the fact that the number of obese type 1 diabetics has been constantly increasing in the last decade, bariatric surgery in these patients is still waiting to be widely used and standardized. Bariatric surgery has been proposed as an effective treatment for these patients, although data are scarce, based on case reports and retrospective studies. The article summarizes the current knowledge about the use of bariatric surgery in type 1 diabetics with obesity an cites some of the previous studies. Bariatric surgery is not yet routinely recommended in patients with type 1 diabetes mellitus.","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81427320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Azathioprine in the therapy of paediatric inflammatory bowel disease – part II: pharmacodynamics, pharmacokinetics, and the possibilities of measuring its metabolites in clinical practice","authors":"Kristýna Pospíšilová, J. Bronský","doi":"10.48095/ccgh2021508","DOIUrl":"https://doi.org/10.48095/ccgh2021508","url":null,"abstract":"Summary Background: Thiopurines (predominantly azathioprine and mercaptopurine) are widely used in paediatrics to maintain remission in the treatment of inflammatory bowel disease. After its absorption from the gastrointestinal tract, azathioprine is converted into 6 mercaptopurine in approximately 90%. Several enzymes (such as thiopurine methyltransferase, xanthine oxidase and hypoxanthine-guanine phosphoribosyl transferase) participate in its further metabolism, producing non-active methylated metabolites (6 methylmercaptopurine) and thiouric acid and active 6-thioguanine nucleotide. The concentration of these metabolites can be measured in red blood cells. Aim: To map the benefits and possibilities of thiopurine metabolites measurements in patients suffering from inflammatory bowel disease. Conclusion: The measurement of active and non-active metabolites can help evaluate the bioavailability of those drugs, identify some causes of adverse effects and reveal non-adherence. Keywords Crohn’s disease, merkaptopurin, pediatrie, thiopuriny, ulcerative colitis","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91157029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biosimilars monoclonal antibodies in the therapy of inflammatory bowel diseases An important milestone in the development of Crohn’s disease and ulcerative colitis therapy, or just a sophisticated generic?","authors":"M. Lukáš","doi":"10.48095/ccgh2021550","DOIUrl":"https://doi.org/10.48095/ccgh2021550","url":null,"abstract":"Summary: In 2013, EMA approved the fi rst biosimilar infl iximab CT-P13 for clinical practice in all indications of the original infl iximab. Since 2015, biosimilar infl iximab has been extensively used in patients with Crohn‘s disease and ulcerative colitis also in the Czech Republic. Biosimilar infl iximab is very similar to the original infl iximab in terms of its macromolecular structure, and its clinical eff ects, adverse events and immunogenicity are identical to those of the original infl iximab. Biosimilar biologics which have been introduced in clinical practice signifi cantly reduced therapeutic costs and improved access to an innovative therapy and facilitated a new therapeutic strategy, with pro-active drug monitoring and fl exibility in dosing. Biosimilars are associated with a signifi cant improvement in the therapeutic armamentarium, which makes them one of the important therapeutic milestones in the treatment of infl ammatory bowel disease. Key words: bio similars – bio logic therapy – Crohn’s disease – ulcerative colitis","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87227756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The indications for performing colonoscopy in Iranian children – a cross-sectional study","authors":"S. Dehghani, Mahshid Doosti, I. Shahramian, H. Mirzaie, F. Parooie, M. Salarzaei, M. Ataollahi","doi":"10.48095/ccgh2021515","DOIUrl":"https://doi.org/10.48095/ccgh2021515","url":null,"abstract":"Background: Colonoscopy is the gold standard dia­gnostic method for colon diseases providing an excellent view of the mucosal surface of the colon and terminal ileum. Colonoscopy in children is indicated for dia­gnosis and treatment of gastrointestinal diseases. In this study, we evaluated the reasons for performing colonoscopy in children. Methods: This was a descriptive cross-sectional study including all children referred for colonoscopy to the Gastroenterology clinic affiliated with the Shiraz University of Medical Sciences. The children were selected by a convenient sampling method. Statistical analysis was conducted in the SPSS 22 software. Results: From 389 children referred for colonoscopy, 203 were boys and 186 were girls. The mean age was 8.36 ±4.8 years. The most common reason for colonoscopy was rectal bleeding (63.5%) with the most prevalent dia­gnoses being juvenile polyp and inflammatory bowel disease, each accounting for 11.3% patients. Conclusions: The most common findings of colonoscopy were polyp, IBD and colon inflammation, and the most prevalent symptoms leading to colonoscopy were rectal bleeding, chronic diarrhea, IBD treatment follow-up, suspected IBD and abdominal pain. The high prevalence of pediatric patients presenting with these symptoms indicates the increasing importance of colonoscopy in these patients. Keywords colonoscopy, gastrointestinal bleeding, inflammatory bowel disease, gastrointestinální onemocnění","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78857307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Janus kinase inhibitor in modern treatment of ulcerative colitis","authors":"K. Michnová","doi":"10.48095/ccgh2021567","DOIUrl":"https://doi.org/10.48095/ccgh2021567","url":null,"abstract":"","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86571820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diet after bariatric surgery in practice","authors":"K. Hlavatá","doi":"10.48095/ccgh2021529","DOIUrl":"https://doi.org/10.48095/ccgh2021529","url":null,"abstract":"Summary: Bariatric-metabolic surgery is associated with many health benefi ts and improved quality of life. However, the resulting eff ect largely depends on the patient’s compliance and willingness and ability to adopt a new diet, which is associated with bariatric procedures. A whole team of experts plays an important role in preparing the patient for this change. Appropriately composed diet and adherence to the frequency and size of portions is essential in the prevention of nutritional defi ciencies. The bariatric food pyramid is a suitable helper for the implementation of nutritional recommendations. Key words: main nutrients – energy intake – bariatric food pyramid – bariatric plate","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89304654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and endoscopic intervention in rare MALT lymphoma of the proximal jejunum","authors":"Tomáš Drašar, Lenka Nedbalová, T. Zajíc, T. Jirásek","doi":"10.48095/ccgh2021432","DOIUrl":"https://doi.org/10.48095/ccgh2021432","url":null,"abstract":"Summary: Extranodal lymphoma from the marginal zone mucosa-associated lymphoid tissue (MALT lymphoma) is one of the primary extranodal non-Hodgkin‘s lymphomas with low degrees of malignancy but with the risk of spreading to distant locations in the body. B-lymphomas are sometimes associated with other diseases (eg. Helicobacter pylori and Campylobacter jejuni infections or inflammatory bowel disease). B-lymphomas may manifest with a variety of clinical signs, from dyspeptic syndrome with malabsorption and weight loss to ileus or massive gastrointestinal bleeding. Dia­gnosis is based on the clinical condition and the results of laboratory tests and imaging techniques, while endoscopy is the essential procedure for visualizing the tumor mass and collecting a bio­psy sample to determine the definitive histopathological dia­gnosis. MALT lymphoma treatment is managed by oncologists and includes chemotherapy and/or radiotherapy, with resection indicated in rare cases. In this case report we present an elderly female patient who was referred to our IBD centre for non-specific abdominal pain with a positive fecal occult blood test. Computed tomography (CT) examination was used before endoscopy and showed an infiltration of the splenic flexure by an unspecified mass, a subsequent colonoscopy showed intact mucosa of the colon, including the terminal ileum. In the second reading of the CT scan the location of the infiltrate was identified more specifically as the area of the proximal jejunum and jejunal mesentery. Subsequent upper endoscopy revealed a stenosing exulcerated tumor in the proximal jejunum, with the stenosis impassable even for a pediatric colonoscope. The dia­gnosis of MALT lymphoma was confirmed by a histological examination of the bio­psied tissue. A follow-up upper endoscopy was performed after the patient had completed her oncological treatment (chemotherapy in combination with radiotherapy), showing the presence of stenosis at the proximal jejunum, still impassable for the endoscope. In clinical terms, the patient experienced weight loss, which was to some extent caused by intermittent pseudo-obstruction when on a solid diet, therefore we decided to enrich her oral intake with high-calorie sip feed. The next follow-up CT scan of the abdomen showed a regression of the infiltrate, but the stenosis of the proximal jejunum, about 7 centimeters long, persisted. To respect the patient‘s wishes, no surgical resection of the stenotic section of the intestine was performed, but we proceeded with endoscopic dilatation of the stenotic section of the jejunum with a balloon. After the first two endoscopic dilatations of the stenotic area the patient experienced a temporary improvement in solid food tolerance. Because of restenosis, a third endoscopic dilatation was performed, with the development of complications that included short-term circulatory instability with abdominal pain and eventually required an urgent surgical solution. Key words: margina","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84404716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How the treatment of gastrointestinal tract disorders may be infl uenced by the kidneys","authors":"M. Merta","doi":"10.48095/ccgh2021445","DOIUrl":"https://doi.org/10.48095/ccgh2021445","url":null,"abstract":"Summary: The treatment of gastrointestinal tract (GIT) diseases may, under specific conditions, be significantly influenced by the kidneys or by kidney disorders. One of the potential scenarios of such interaction is the concurrent involvement of the kidneys and the GIT organs within one disorder, another option being the negative impact of impaired renal function on the prognosis of the GIT disease and, finally, the need for an adequate choice and dose adjustment of renally eliminated medication to avoid nephrotoxicity. Renal impairment may occur as an adverse effect of the treatment of the GIT condition and may limit further therapy. In this context we have recently focused on the following clinical situations: the development of acute kidney injury during treatment with proton pump inhibitors, renal complications of inflammatory bowel disease management and the development of acute phosphate nephropathy due to the use phosphate containing laxatives. An early identification of the mechanisms leading to renal injury can prevent the development of irreversible renal lesions and facilitate an efficient treatment of the GIT. Key words: treatment of gastrointestinal tract disorders – acute kidney injury – proton pump inhibitors – renal complications of inflammatory bowel disease – acute phosphate nephropathy","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91300876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}